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Eye Opening Report on Hospital and Physician Medicare Fraud

By: Jeff Powless September 19, 2012 2 responses

Eye Opening Report on Hospital and Physician Medicare Fraud

Health care dollars that could be spent on finding ways to reduce medical malpractice and improve patient safety appears to be falling victim to healthcare fraud and abuse.  A recent investigation by the Center for Public Integrity found that fraudulent billing practices by hospitals and physicians appears to be on the rise, wasting billions of dollars that could be better spent.

According to the Center’s report, doctors and other healthcare providers have, over the last decade, steadily billed higher rates for treating elderly patients and thereby  increasing their fees by more than $11 billion.  While there was little evidence indicating that Medicare patients were sicker than in prior years, or that the healthcare providers were rendering more care, analysis of claims from 2001 through 2010 indicated that the health care providers were using more lucrative billing codes.  The process of billing for more expensive services than were actually provided is called “upcoding.”

Healthcare dollars spent paying for fraudulent “upcoding” could be spent finding ways to prevent medical errors, improve patient outcomes, and reduce healthcare costs.  If you suspect fraud associated with your Medicare bills, you can report fraud by calling the Inspector General’s fraud hotline at 1-800-HHS-TIPS (1-800-447-8477).


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